Kornimate/medical-research-clean huggingface dataset:
visn 23 chronic obstructive pulmonary disease (copd) case management using home telehealth equipment

Conditions: COPD

Summary: looking at the use of home telehealth equipment and it's place in self management and education in patients who suffer moderate to severe chronic obstructive pulmonary disease (copd). the patients in this group would be those patients who traditionally suffer from emphysema, and/or chronic bronchitis.

patients who have been admitted to the hospital, or who have frequent urgent care visits, who also suffer from copd exacerbations will be given a home monitoring system. daily, the patient will respond to a series of questions. the results of the question answers will be remotely monitored by a nurse case manager. the objective is to measure compliance, resource use, and the ability for early recognition of an exacerbation of their copd, and early implementation of therapy.

Eligibility criteria:
inclusion criteria: * one or more hospital admissions or emergency room visits in last 2 years. * patient must meet the va home telehealth guideline that the patient is determined to be at high risk for poor clinical outcomes or increased unplanned health care utilization based on disease specific criteria and/or determined by physician provider exclusion criteria: * any unstable medical condition that the investigator thinks would preclude effective participation in the study, or which would be expected to reduce life expectancy to less than 1 year. * unwilling or unable to provide consent * uncooperative or combative * does not have a compatible phone line * inability to use home telemedicine equipment

Keywords: telehealth oximetry copd
reducing pain in four- to six-month old infants undergoing immunization using a multi-modal approach

Conditions: Pain From Immunization

Summary: the aim of this study is to answer the following question: in healthy infants aged four to six months undergoing routine immunization for diphtheria, tetanus, acellular pertussis, inactivated poliovirus and haemophilus influenzae type b (dtap-ipv-hib) and pneumococcal conjugate vaccine (pcv) while receiving a combination of proven analgesic interventions (least painful injection technique, holding by parent, and oral sucrose solution) and non-procedural talk by the parent, does the addition of rubbing near the site of injection reduce pain as measured by the modified behavioral pain scale (mbps) to a greater extent than no rubbing?

immunization is a significant source of pain and distress for infants. at present pain-relieving interventions are rarely employed to manage this pain. there are many non-pharmacological methods that can be used to reduce immunization pain. these include: sugar water, fast injection without aspiration, holding infants during the procedure, and non-procedural related parental behaviours such as distraction. at present, there are no studies of tactile stimulation during noxious procedures in infants and its effectiveness, therefore, is unclear. light rubbing of the skin near the injection site that is administered by a parent immediately before, during and immediately after immunization is an easily learned, cost neutral intervention that could offer improved pain management.

Eligibility criteria:
inclusion criteria: * healthy infants * 4 to 6 months old * routine immunization with dtap-ipv-hib and pcv exclusion criteria: * impaired neurological development * history of seizure * use of topical local anaesthetics at the injection site * use of sedatives or narcotics in the preceding 24 hours * fever or illness that would prevent administration of the vaccine * parent is unable to use the assessment tools in the study * parent does not speak english * prior participation in this trial

Keywords: tactile stimulation pain immunization infant
high sensitivity troponin t levels following dc cardioversion for atrial fibrillation / atrial flutter

Conditions: Atrial Fibrillation; Atrial Flutter

Summary: the purpose of this study is to determine if there is a rise in serum high sensitivity troponin t (a marker for heart muscle injury) following a direct current cardioversion (shock therapy) used for patients with atrial fibrillation. this will help us determine if direct current cardioversion results in damage to the heart muscles in a sufficient amount to cause a rise in high sensitivity troponin t.

high sensitivity troponin t is a relatively new biomarker that is highly sensitive and specific for myocardial injury. its widespread use has helped in the determination and investigation for myocardial ischemia in patients. previous studies have shown a rise in creatine kinase (ck) and the more specific creatine kinase-mb isoenzyme (ckmb) after dc cardioversion. studies on the earlier generation troponin t found that the levels don't rise or rise only minimally after dc cardioversion. the high sensitivity troponin t has never been studied in the setting of dc cardioversion.

Eligibility criteria:
inclusion criteria: * patients with atrial fibrillation / atrial flutter attending for direct current external cardioversion * age 18 or older exclusion criteria: * myocardial infarction within the last 6 weeks * coronary artery bypass grafting, percutaneous coronary intervention or any other invasive cardiac procedure within the last 6 weeks

Keywords: cardioversion high sensitivity troponin t (hs-trop t) brain natriuretic peptide (bnp) neutrophil gelatinase-associated lipocalin (ngal)
effect of early range of motion following first time patellar dislocation

Conditions: Patellar Dislocation

Summary: do teen-age patients with a dislocated knee cap do better with or without a brace?

this study will look at two different ways to treat teen-age patients who have had a dislocation of their knee cap. both groups will receive the physical therapy treatment for knee cap dislocation but one group will first be in a brace for a week and the other group will start moving in therapy right away.

Eligibility criteria:
inclusion criteria: * male and female adolescents between 11-17 years * medical diagnosis of 1st time lateral patellar instability episode (dislocation or subluxation) * subjective history of knee shifting, instability, popping out, knee effusion * apprehension test is positive and has medial patellar tenderness * referred to the texas children's hospital (tch) outpatient sports medicine clinic from an emergency room facility, urgent care or pediatrician within 10 days of the injury. * free of co-morbidities that would prevent or limit rehabilitation including cardiac, pulmonary, psychiatric (except attention deficit disorder (add) or attention deficit hyperactivity disorder (adhd), orthopedic, neurological * must be able to follow directions and participate in rehabilitation protocol for the 3-month study period. exclusion criteria: * imaging or clinical findings suggest surgical intervention is needed i.e. fracture, osteochondral defect, lachman or other positive knee ligament special tests.
changes of bone turnover markers and bone mineral density after osteoporosis treatment

Conditions: Osteoporosis

Summary: to examine the changes of bone mineral density and bone turnover markers after bonviva treatment in osteoporotic patients


Eligibility criteria:
inclusion criteria: * osteoporosis exclusion criteria: * kidney, parathyroid, congenital bone metabolic disease
preventive health practices in women

Conditions: Cardiovascular Disease

Summary: the purpose of this study is to evaluate women's level of knowledge and health practices regarding cardiovascular health and identify barriers to appropriate health practice.

increasingly, gender differences in manifestation of cardiovascular disease (cvd) and myocardial infarction (mi) are being reported. gender specific presentations of mi in particular have contributed to underdiagnosis of cardiac events in women. furthermore, previous studies from the 2002 behavioral risk factors screening surveillance demonstrated decreased compliance with standard cardiovascular health practices in women compared to men. we seek to validate these findings in a population of women undergoing screening mammography and annual gynecology visit to identify current state of knowledge regarding cardiovascular risk in women.

Eligibility criteria:
inclusion criteria: * women attending screening mammography and gynecology visit. exclusion criteria: * patient refusal to participate (assessed by non-submission of the completed survey).
adrenomedullin changes after sustained inflation or positive pressure ventilation at birth

Conditions: Lung Injury

Summary: in this clinical trial the investigators aimed to assess the adrenomedullin (am) release in urine and plasma in preterm infants undergoing sustained inflation or positive pressure ventilation at birth to manage respiratory failure.

background and objectives: the respiratory management in the dr may play an important role in the development and prevention of lung injury. the sustained lung inflation (si) is a promising approach to facilitate cardio-respiratory transition, but currently, although it has been shown to decrease the duration of mv, seems not to guarantee relevant benefits compared to positive pressure ventilation (ppv). in order to clarify the impact of these two different approaches on lung tissues, this study measures adrenomedullin (am), which is a biomarker involved in lung development. methods: we conducted a prospective case control-study in a cohort of very low birth weight (vlbw) infants (\< 1500 g) of 28+0-30+6 weeks of gestational age (ga), who received si or ppv during stabilization in dr. exclusion criteria were major malformations (i.e. congenital heart disease, cerebral, lung and abdominal malformations), fetal hydrops, lack of parental consent and need for endotracheal intubation at birth. blood samples for am measurement were collected at birth from the arterial umbilical cord before resuscitation maneuvers, then at 1 hour from birth and at 24 hours from birth. moreover, urine samples were collected, in correspondence with the first urine emission while in nicu and at 24 hours of life.

Eligibility criteria:
inclusion criteria: * gestational age between 28+0 and 30+6 * need for respiratory support in the delivery room exclusion criteria: * major malformations (i.e. congenital heart disease, cerebral, lung and abdominal malformations) * fetal hydrops * lack of parental consent. * need for endotracheal intubation at birth
the effect of berry consumption on indicators of cardiovascular disease risk

Conditions: Blood Pressure; Platelet Function; Inflammation

Summary: the purpose of this study is to investigate the effects of berry consumption on indicators of cardiovascular disease risk (blood pressure, cardiovascular biomarkers, nutrigenomics).

the study has a randomized crossover design. it consists of two 8-wk dietary treatments, with no washout period between periods. the participants are blinded to treatments. the subjects are randomly assigned to either a berry diet or a control diet which they follow for 8 weeks. after that they are crossed over to the other diet for another 8 weeks. the main visits to the study site are at baseline and after 8 and 16 weeks (for blood pressure measurement/ cardiovascular measurements and sample collection). the additional visits are at 4 and 12 wk; these visits are for compliance checks, meeting the study nurse and receiving the study products. the subjects are asked to maintain their normal dietary and lifestyle habits, as well as to keep alcohol intake and physical activity constant during the study.

Eligibility criteria:
inclusion criteria: * mild hypertension (systolic blood pressure 130-159 mmhg, diastolic blood pressure 85-99 mmhg) exclusion criteria: * smoking * regular use of medications (except hormone replacement therapy) or dietary supplements * intestinal disorders * obesity (bmi\> 35 kg/m2) * vegetarianism * pregnancy

Keywords: human intervention blood pressure cardiovascular risk factors polyphenols bioavailability
detection of keratoconus progression using machine learning

Conditions: Keratoconus; Machine Learning

Summary: keratoconus (kc) is a bilateral ocular disease characterized by progressive thinning and steepening of the cornea, usually in its inferotemporal region. the disease often occurs asymmetrically as one eye is more severely affected by the condition. the changes underlying kc lead to the generation of irregular astigmatism resulting in diminished visual acuity of the patients and can even lead to axial corneal scarring in advanced stages. the disease usually occurs in the second or third decade of life, but can develop at any age. kc is a complex condition involving environmental factors such as age, eye rubbing, contact lens use, atopy, sun exposure, hormones, toxins, as well as a genetic component. however, how these factors contribute to the disease is still unknown and intraindividual differences might exist. kc can be categorized into different forms based on the stage of the disease. in clinical kc, there are both topographic and slit lamp findings of the disease. the importance of corneal epithelial imaging in the diagnosis of keratoconus has been further demonstrated in several clinical studies. as new anterior segment optical coherence tomography (as-oct) devices provide more detailed measurements for instance of the corneal epithelium. this layer could therefore be an interesting marker for the prediction of kc progression and contribute to earlier diagnosis as well as better outcome of the disease. the aim of this retrospective study is therefore to determine whether different topographical and volumetric data, for instance epithelial thickness maps (etm), can be reliably used to predict the progression of kc using a machine learning algorithm.


Eligibility criteria:
inclusion criteria: * patients with kc progression as defined dependent on kmax/year: o 1. kmax \ 0.5 d per year o 2. kmax 48.01-53 d: \>0.6 d per year o 3. kmax 53.01-58 d: \>0.8 d per year o 4. kmax \> 58 d: \>1.5 d per year - non progressive group: patients with stable kc (kc progression dependent on kmax \< than the values described above/year) exclusion criteria: * relevant other ophthalmic diseases that are likely to influence the measurement outcome like corneal scars or epithelial dystrophies * too few measurements/too short follow-up to define progression of kc

Keywords: keratoconus machine learning
glucobrassicin-brussel sprout effect on d10 phe metabolism

Conditions: Smoking

Summary: to determine whether glucobrassicin-rich brussels sprouts can favorably modify the metabolism of the polycyclic aromatic hydrocarbon deuterated phenanthrene (\[d10\]phe) in current and former smokers

subjects will be given 1 microgram of \[d10\]phe, and all urine will be collected for 6 h afterwards to quantify baseline levels of \[d10\]phenanthrene tetraol (\[d10\]phet) and \[d10\]phenanthrols (\[d10\]hop). within 3 days of this baseline measurement, subjects will consume 200 micromoles of glucobrassicin in the form of raw brussels sprouts (\~200-300 grams) at the study center once daily for 7 consecutive days. urine will be collected for 24 h after vegetable consumption on days 3 ± 1 and 6 of the feeding intervention for 3,3'-diindolylmethane (dim) quantification. on day 7 of the feeding intervention, a second dose of 1 microgram of \[d10\]phe will be administered at the study center after vegetable consumption, followed by another 6 h urine collection.

Eligibility criteria:
inclusion criteria: * adult ≥ 18 years old * current or former smoker by self-report * willing to abstain from cruciferous vegetable consumption other than the study vegetable during the study period * able to understand the experimental nature of the study and provide informed consent * negative urine pregnancy test for women of childbearing potential within 7 days of baseline \[d10\]phe dosing exclusion criteria: * chronic proton pump inhibitor, h2-blocker (i.e., ranitidine, famotidine), and/or calcium carbonate use * history of gastric bypass surgery, gastric banding, bowel resection, malabsorption syndromes such as celiac sprue or pancreatic insufficiency, or other conditions that may affect gastric absorption * current use of tobacco products other than cigarettes (i.e. snuff, snuz, smokeless tobacco, cigars, pipes) or use of these products within 3 months of study registration * major or chronic medical disease, including heart disease, poorly controlled diabetes, etc., to be adjudicated by the principal investigator * women who are pregnant, intend to become pregnant within 3 months of the study period, or who are breastfeeding * current or recent (within 12 months) problems with drug use or alcohol dependence by self-report antibiotic use within 2 months of study enrollment or during the study by self-report alcohol dependence, abuse, or history of dependence/abuse by self-report vegetarians * history of respiratory tract cancer * use of metronidazole or antabuse during the study * taking ibuprofen, naproxen, other nsaids, steroids (except inhaled steroids) within 14 days of study registration * allergy to brussels sprouts

Keywords: smoker former smoker
effects of preoperative fasting on ecg and vital parameters

Conditions: Fasting; Intraoperative Complications; Ischemia

Summary: this study compares differences in hemodynamic ve ecg parameters of patients undergoing urological or orthopedic surgery under spinal anesthesia. first group will comprise of patients undergoing surgery in the morning hours; thus with a standard fasting duration (8 hours), and the second group will comprise of patients undergoing surgery afternoon; thus having a prolonged fasting duration (\>12 hours).

patients who are scheduled for surgery in surgical wards are routinely fasted after 12am on the day of the surgery regardless of the planned hour of the surgery. this results in a near standard fasting for patients with a planned surgery time in morning hours of the day. however, patients with a planned surgery time in the afternoon hours of the day are fasted more than 12 hours. this situation may not look very important for a healthy young adult but considering that the patient population in a hospital is mostly consisted of sick and elderly people, fasting and associated dehydration may have serious deleterious effects. our objective is to observe and define these potential deleterious effects with a special focus on cardiovascular system of the patients.

Eligibility criteria:
inclusion criteria: * patients over 60 years of age * patients with an asa (american society of anesthesiologists) physical status score of 1, 2 or 3 * patients scheduled for elective orthopedic or urological surgery under spinal anesthesia exclusion criteria: * patients requiring emergency surgery * patients under 60 years of age * rejecting to participate in the study * contraindications to spinal anesthesia * evidence of myocardial ischemia in baseline electrocardiogram prior to surgery * conditions mimicking electrocardiographic signs of myocardial ischemia (e.g. electrolyte imbalances such as hypokalemia)
foley catheter for labor induction in women with term and near term membrane rupture

Conditions: Fetal Membranes, Premature Rupture; Labor, Induced/IS

Summary: in women undergoing labor induction for membrane rupture at or near term, we are investigating the addition of a foley catheter placed in the cervix to standard therapy (oxytocin administration) to decrease the time from the start of the induction to delivery.

to compare the efficacy of a transcervical foley catheter with concurrent oxytocin administration compared to oxytocin infusion alone for cervical ripening and labor induction in women with premature rupture of membranes (prom) at \> 34 weeks.

Eligibility criteria:
inclusion criteria: 1. preterm rupture of membranes (prom) (rupture of membranes = pooling/ferning/nitrazine +) rupture of membranes (rom) for ≥1 hour prior to starting induction 2. cervix ≤ 2 centimeters (cm) 3. gestational age ≥ 34 weeks by best obstetric estimate and clinical management decision is delivery 4. singleton gestation 5. cephalic 6. vertex well applied to cervix exclusion criteria: 1. regular uterine contractions (contractions more frequent than every 5 minutes) 2. two prior transverse uterine incisions/vertical uterine incision/ transmural myomectomy or any obstetric contraindication to labor 3. evidence of chorioamnionitis (temperature of 100.4°f with uterine tenderness and maternal or fetal tachycardia or purulent discharge) 4. lethal fetal anomalies 5. intrauterine fetal demise (iufd) 6. previa 7. suspected abruption/significant hemorrhage 8. non-reassuring fetal heart rate (fhr) pattern 9. non vertex fetal presentation

Keywords: fetal membranes, premature rupture labor, induced foley catheter
transepithelial corneal cross-linking using iontophoresis

Conditions: Progressive Keratoconus

Summary: the purpose of the present randomized clinical trial (rct) is to compare the efficacy and safety of transepithelial corneal cross-linking using iontophoresis (t-ionto cl) to treat progressive keratoconus in comparison with standard cross-linking (standard cl).

keratoconus is a progressive corneal ectatic disease causing visual impairment by inducing irregular astigmatism and corneal opacity. this disorder typically begins during the second decade of life and, in severe forms, may need a corneal transplantation. corneal cross-linking with riboflavin and uv-a is a procedure intended to halt keratoconus progression. it generates additional chemical bonds between stromal proteins in order to stiffen the corneal tissue. standard cl includes epithelial removal and stroma soaking with dextran-enriched 0.1% riboflavin solution for 30 minutes before being exposed to ultraviolet-a radiation using a 3mw/cm2 lamp for 30 minutes. epithelial debridement exposes the cornea to a risk of side effects, such as pain for the first two post-operative days, temporary loss of visual acuity during the first three months, and serious complications, such as infection and stromal opacity due to corneal scarring. iontophoresis is a non invasive technique in which a weak electric current is used to enhance the penetration of hypotonic 0.1% riboflavin-5-phosphate solution into the corneal stroma through the intact epithelium. after iontophoresis, the corneal tissue is irradiated using a 10 mw/cm2 for 9 minutes (t-ionto cl). from previous experimental work (lombardo m. et al. jcrs 2014 and jcrs 2015), the investigators provided evidence that t-ionto cl increases the stiffness of human corneas with results almost comparable with standard cl. the new procedure holds the promise to be as effective as the standard procedure while minimizing all the related risks. it is object of the present clinical trial to randomize patients with progressive keratoconus to t-ionto cl and standard cl and compare efficacy and safety of treatments.

Eligibility criteria:
inclusion criteria: * diagnosis of progressive keratoconus exclusion criteria: * anterior corneal curvature steeper than 61 d; * central corneal thickness \<400 um * corneal scarring; * descemetocele; * history of herpetic keratitis; * concomitant eye diseases; * inflammatory eye diseases; * glaucoma; * cataract; * pregnancy

Keywords: corneal cross-linking transepithelial corneal cross-linking iontophoresis progressive keratoconus